Organization Active NPI

Gateway Hospice Providers LLC

  • Community Based Hospice Care Agency
  • Burleson, TX
National Provider Identifier
1124636386
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GATEWAY HOSPICE PROVIDERS LLC
Practice address
821 SW Alsbury Blvd Unit a
Burleson, TX 76028-4090
Phone
(682) 499-6669
NPI assigned
Jul 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brandon BaylesNPI 1396192704
Title
Owner
Phone
(682) 499-6669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

821 SW Alsbury Blvd Unit a
Burleson, TX 76028-4090

Mailing address

821 SW Alsbury Blvd Unit a
Burleson, TX 76028-4090

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL 6824996669
Direct Messaging Address admin@gateway-hospice.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210204003160 TX Part A Provider - Hospice 2264846062 Practice locations: Burleson, TX

Hospice certification: CCN 971641

Legal name
GATEWAY HOSPICE PROVIDERS LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 28, 2021
Last certification
Apr 28, 2021
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Enrollment address
821 SW Alsbury Blvd
Unit a
Burleson, TX 76028-4090

Care Compare: Hospice

Medicare Care Compare
Listed as
Gateway Hospice Providers, LLCCCN 971641
Ownership
For-Profit
Certified
Apr 28, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2200250Gateway Hospice Providers, LLC821 SW Alsbury Blvd Unit a, Burleson, TX 76028Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory

Locations

821 SW Alsbury Blvd
Unit A
Burleson, TX 76028
Phone (682) 449-6669

140 W Eldred St
Burleson, TX 76028
Phone (817) 888-5374

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amy Moyer-Stoy Individual W-2 Managing EmployeeDirector of Nursing Apr 30, 2024
Brandon Joe Bayles Individual 5% Or Greater Direct Ownership Interest Jun 3, 2020 50%
Corporate OfficerCeo Jun 3, 2020
W-2 Managing Employee Jun 3, 2020
Melanie Jane Gray Individual Contracted Managing EmployeeMD; Nov 5, 2020
Samuel James Adrignola Individual 5% Or Greater Direct Ownership InterestOwner Jun 3, 2020 50%
Corporate OfficerCoo Jun 3, 2020
W-2 Managing EmployeeCoo Jun 3, 2020
Misty Hightower Individual W-2 Managing EmployeeAd; Aug 17, 2020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1124636386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SW ALSBURY BLVD UNIT A",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SW ALSBURY BLVD UNIT A",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284090",
            "telephone_number": "682-499-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY HOSPICE PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "BAYLES",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-499-6669",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "6824996669",
            "affiliation": "N",
            "address_1": "821 SW Alsbury Blvd Unit A",
            "city": "Burleson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760284090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@gateway-hospice.com",
            "affiliation": "N",
            "address_1": "821 SW Alsbury Blvd Unit A",
            "city": "Burleson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760284090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.